Provider Demographics
NPI:1457687535
Name:RENGEN, LAUREN (NP-C)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:RENGEN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 WILLIAM WAY
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-9538
Mailing Address - Country:US
Mailing Address - Phone:717-697-4643
Mailing Address - Fax:
Practice Address - Street 1:100 WITMER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2251
Practice Address - Country:US
Practice Address - Phone:215-442-5000
Practice Address - Fax:215-957-2875
Is Sole Proprietor?:No
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN522608L146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN522608LOtherLICENSE